Präzisionsonkologie, molekulares Tumorboard und translationale Programme beim metastasierten Mammakarzinom

Drug therapy of metastatic breast cancer is becoming increasingly individualized. Precision oncology opens up new perspectives for patients. Based on a better understanding of tumor biology and the increasing use of new high-throughput sequencing methods using large gene panels, it is already possible to identify a number of molecular biomarkers that enable personalized and targeted therapy. In metastatic breast cancer, in addition to hormone receptor and HER2 status, a number of biomarkers with associated therapeutic relevance have already been described in the recommendations of the ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT) [1], including gBRCA mutations, ERBB2 amplifications, ESR1 and PIK3CA mutations, NTRK fusions, and microsatellite instability high (MSI-H).

The establishment of molecular tumor boards (MTBs) is important in order to optimize care and enable sustainable patient-oriented science, as the complexity of advanced molecular diagnostics requires an interdisciplinary exchange between various disciplines. In this tumor entity, data have already been published showing improvements in progression-free survival (PFS) through the implementation of therapies recommended in the MTB for this patient group.

The use of advanced molecular diagnostics and the discussion of their results in MTBs could further optimize the treatment of patients with metastatic breast cancer. Accordingly, the selection of all suitable patients and the availability of advanced molecular diagnostics is essential. The potential of precision oncology for our patients can only be exploited through the programmatic linking of diagnostics, specialist expertise within the MTB, and access to innovative therapeutics. At this point, we would like to provide an overview of the German precision oncology landscape in the field of metastatic breast cancer.